A case of post-infantile giant cell hapatitis with positive of LE cell, antinuclear antibody.

Abstract

A 41-year-old woman was admitted to our hospital with jaundice and general fatigue. Liver function tests revealed elevation of total bilirubin and transaminase with marked gammaglobulinemia. Serum antinuclear antibody, anti-DNA antibody and LE cell were positive. All viral markers were negative. Predonisolone, 40mg/day was prescribed and a rapid improvement was observed in transaminase, total bilirubin and gammaglobulin. 141 days later, liver biopsy was performed, which revealed marked multinucleated giant cell infiltration. Multinucleated giant cell transformation is a common histological feature of several types of liver disease in the neonatal period. However, the presence of a number of Multinculeated giant cells in the liver is rare, later in life. It is noteworthy that Post-infantile giant cell hepatitis occurred in association with positive of LE cell, antinuclear antibody.

Post-infantile giant cell hepatitis in an elderly female patient with systemic lupus erythematosus

“…In Japan, one case of post-infantile giant cell hepatitis has been reported, in which the patient showed a rapid improvement after treatment with prednisolone 40 mg/day. 13 In our patient, a beneficial result was obtained with prednisolone and/or cyclosporine treatment, and the combined immunosuppressive regimen with prednisolone and azathioprine was effective while the transaminase and total bilirubin levels fell to the normal range after the therapy. Is,19 However, we failed to determine the long-term effectiveness of this regime because the patient died of renal failure and pneumonitis.…”

“…Devaney et al ~ and Kobayashi et al 13 reported that patients with post-infantile giant cell hepatitis responded effectively to prednisolone.…”